| Objective:Analysis of clinical data and connected laboratory examination results of several children with chronic spontaneous urticaria,and a number of data were compared with those of healthy controls to provide reference for clinical diagnosis and treatment in assessing the severity of the condition of children,judging the course of disease,and guiding treatment.Methods:From October 2020 to January 2023,68 children with chronic spontaneous urticaria diagnosed in the outpatient department of Jiangxi Provincial Dermatology Special Hospital were collected as the case group,and 68 healthy children in the same period were selected as the control group.Clinical data questionnaire survey and relevant laboratory tests(including sensitive screening specific IgE and total serum IgE counts,blood routine,C-reactive protein,complement C3,complement C4,general bacterial culture,and blood vitamin D levels)were conducted in the case group,and the results were statistically analyzed.At the same time,some laboratory tests were compared with the control group(including blood routine and C-reactive protein),and these hematological markers were compared with the activity of children’s CSU A correlation analysis was conducted between the course of disease and the efficacy,with a view to evaluating and predicting the outcome of the disease or treatment responsiveness.Results:1.A total of 68 children with CSU were collected in the case group,with a male to female ratio of 2.4:1 and an average age of(6.13 ± 3.46)years.Among them,The higher age group(>7 years old)accounts for 33.82%,and the lower age group(≤ 7 years old)accounts for 66.18%;The course of disease is 1.5 months to 5 years,with a median course of 4 months;At the time of visit,17 cases had a UAS7 score of less than 15 points,25 cases had a score of 15-28 points,and 26 cases had a score of more than 28 points.The severity of the disease was mainly mild to moderate;Of the 60 children who had received antihistamine therapy,10(16.67%)were definitely effective,46(76.67%)relapsed after discontinuation,and 4(6.67%)were ineffective.2.Specific allergens were 67.16%(45/67)positive,and the top three allergens were dust mites,household dust mites,and milk;The top three positive rates of food allergens were milk,shrimp/crab,beef/lamb,and peanuts/soybeans,while the top three positive rates of inhalation allergens were dust mites,household dust mites,and candida,Mycobacterium penicillatus,Alternaria niger;The positive proportion of food allergens in children in the elderly group was significantly lower than that in the younger group(p =0.045).The total IgE antibody level in serum was higher than the normal value,accounting for 61.19%(41/67).There was no significant correlation between the total IgE antibody level and age,course of disease,severity of the disease,and the effectiveness of antihistamine therapy(p =0.570,0.867,0.480,0.107,respectively).3.In the case group,there were 8 strains of Staphylococcus aureus in pharyngeal cultures,ranging in age from 7 to 13 years old,and 1 strain of Streptococcus pyogenes;38.46%(25/65)of the patients had lower complement C3 than the normal value,and 32.31%(21/65)had lower complement C4 than the normal value;The serum 25(OH)D level in children with low age was significantly lower than that in children with high age(p =0.003).4.The levels of PLT and CRP in the case group were significantly higher than those in the control group(p values were 0.000 and 0.003,respectively),and the MPV,PDW,eosinophil,and basophil counts were significantly lower than those in the control group(p values were 0.000,0.000,0.002,and 0.015,respectively).PLT is significantly negatively correlated with MPV and PDW levels(ρ =-0.451 and-0.371,respectively,with p values of 0.000 and 0.002);There was a significant positive correlation between basophil count and eosinophil count(r=0.284,p =0.019).5.The levels of serum MPV and PDW in the case group were significantly positively correlated with the course of disease(ρ The total IgE antibody level,complement C3,C4,25(OH)D level,eosinophil and basophil counts,PLT,and CRP levels were not correlated with the course of disease(p values were 0.867,0.386,0.257,0.752,0.969,0.665,0.944,and 0.280,respectively);There is a significant negative correlation between CRP levels in children and the efficacy of previous antihistamines(ρ =-0.325,p =0.011),there is a statistical difference in the number of cases of reduced complement C4 levels between the group with positive efficacy and the group with reduced condition in the efficacy of antihistamines(Χ2=24.245,p =0.000),while eosinophil and basophil counts,25(OH)D levels,PLT,MPV,PDW,total IgE antibody levels,and complement C3 were not correlated with the efficacy of previous antihistamines(p values were 0.290,0.960,0.713,0.242,0.865,0.653,0.107,and 1.000,respectively);Serum 25(OH)D levels in children are significantly negatively correlated with disease severity(ρ =-0.433,p =0.000).In 21 children with lower than normal levels of complement C4,their values were significantly negatively correlated with disease activity(ρ =-0.562,p =0.008),while eosinophil and basophil counts,PLT,MPV,PDW,CRP,and total IgE antibody levels were not correlated with disease severity(p values were 0.121,0.968,0.414,0.628,0.436,0.356,and 0.480,respectively).Conclusion:1.The results of this study show that the proportion of children in the low age group(≤ 7 years old)is higher than that in the high age group(>7 years old),with more boys than girls.2.Children with CSU often have exogenous allergies,with dust mites predominating in inhalation and milk predominating in ingestion.Anti histamines are the main drugs used in the treatment of CSU in children,and adequate treatment courses must be maintained.3.Attention should be paid to ruling out the possibility of Staphylococcus aureus infection in older children ≥ 7 years old.4.Children with CSU often have hypocomplementaemia(C3,C4),and lower levels of C4 are negatively correlated with the severity of the disease;There is also a significant positive correlation between the decrease in peripheral blood eosinophil and basophil counts.5.Platelet related parameters such as PLT,MPV,and PDW can be used as potential biomarkers in children with CSU.Decreased levels of MPV,PDW,and elevated levels of PLT can be considered indicators of inflammation in children with CSU,and may include platelets in one of the treatment strategies for the disease.6.CRP levels in children’s CSUs can be used to predict the responsiveness of children to antihistamine treatment.7.Vitamin D levels are significantly negatively correlated with CSU disease activity in children,which can be used to assess disease activity.In clinical practice,appropriate supplemental treatment may be considered for children with low vitamin D levels. |
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